First baby, low risk - buy an Aniball and train for a Vbac or give in to fear and ask for an elective

[Plimsongrey]

First baby
Smooth pregnancy so far, considered low risk
BMI of 20.5
Active lifestyle

Now 30 weeks at a crossroads - do I go the full hog and prepare for natural birth? Aniball hypnobirthing techniques etc or do I just request an a elective as deep down I'm shit scared of a traumatic birth and don't like the Russian roulette of a vbac.

I have an appointment to discuss an elective next week but I can't say I'm 100% adamant about it, I just want it on the table in case I bottle it. Part of me want to be courageous and try vbac, the other part things that's bonkers.

I've had a c-section and a vbac, and I would say they are roughly the same where, pain, recovery, etc. are concerned. A c-section is not a free "get out of discomfort" card.

That's because they consider that epidurals are the only form of pain relief that really work well for women in labour, and they don't believe they lead to worse outcomes, so why wouldn’t you have one?

I can't really comment on gas and air as I've never had it (apart from very briefly for stitches in my finger, when I found it very underwhelming), but it seems that many countries don't use it due to the adverse effects of overexposure for the midwives and doctors.

Using warm water as pain relief is becoming more popular in France and I was offered both the use of a bathtub and a hot shower when I was in early labour. But this is mainly for women who are aiming to give birth without any pain relief at all (which some women would like to try), or as a precursor to the epidural (which most women are happy to have).

My little girl is 6m old now and I was like you, would have much preferred an elective c section than a vaginal birth that went haywire and ended up with induction/forceps/emergency section just to take all the scary unknown out of it.
I did the online hypnobirthing course by the positive birth company, loads of research and also watched hundreds of positive birth vlogs on YouTube of all types of birth (water/section/induction/home etc) to really familiarise myself with what MY birth could look like.

In the end my labour was amazing, I'm very lucky but if I could guarantee it went like that every time I'd have 100 babies. I did end up with the fairytale no pain relief waterbirth no tearing or stitches which while I know is partly luck I also massively put down to how much research I did into understanding the physiological process of labour and what my body was doing so I was never scared or confused about what was happening and trusted myself that I could do it.

There's so many horror stories out there and labour doesn't go smoothly for all women but I think it's important for expectant mums to know that it can and does go smoothly for lots of women too! Good luck with the rest of your pregnancy and I hope however your baby comes into the world you have a positive experience

That makes sense.

In my recent labour I asked the anaesthetist not to dose the epidural too heavily, partly because I was afraid of not being able to feel early pain in my C-section scar area in case of rupture, and partly because I was planning to rest for an hour or so and then try and get up and move around a bit to help things along.

He did as I asked, but in the end I didn't have time to move around because an hour later I was almost ready to push. I felt the urge to push very intensely and certainly didn't have any difficulties using the right muscles. But I do think my epidural was lightly dosed, because they offered to top me up, which I declined. And although I didn't feel the tearing, I did feel quite a bit of discomfort when the doctor started doing the stitches, so she gave me a local anaesthetic to take away the sting, which probably wouldn't have been necessary if the epidural had been stronger.

I definitely think a fairly light dose is the best compromise between relieving the pain and not inhibiting the progress of your labour.

Anyway, the anaesthetists who performed both my epidurals both made a huge (positive) difference to my two labours.

Beyond gas and air and paracetamol its by far the safest pain killer for baby. Can't say I've heard of an anaesthetic colleague using anything else, nearly all have epidurals if not mega fast labourers.

All opiates transfer to baby to a lesser extent, pethidine isn't a decent painkiller it just makes you drowsy/less with it, so less aware of pain, if it was a proper painkiller it would be used outside of midwife admin. Diamorph is better but there's a national shortage of it and it def makes baby sleepy. Remifentanil is a super short acting one in patient admin click button device but units rarely use it and its not normally enough to see a first time mum through (but good for 2nd+ babies when baby is nearly there and just need a bit more to get through the last bit

Theres a real issue with gas and air toxicity on labour wards so lots of units are having to temporarily stop while sort out scavenging (strong assoc with miscarriage in staff that work on LW)

But on the non epidural front, the best best pain relief support is a decent birthing partner that'd there for you and does what you need, can't be underestimated (the blokes sat there going "there there darling it's OK baby your doing great baby" drive me mad, and I'm only there for the 20min to do an epidural haha. The birthing pool, aromatherapy all do wonders.

Really don't underestimate tens machines they really are fantastic I use them for chronic pain myself, you can hire if don't want to buy but decent ones are only 30quid on amazon and the like

Highly recommend this website www.labourpains.com/home

Written by anaesthetists for patients really simply and well explained

@Destiny123 this is all great information, thank you for sharing.

From my own perspective, I proper scoffed when my NCT teacher suggested warm water as a pain relief in labour. Then I had a water birth and OMG it was amazing. Combined with a tiny bit of gas and air I had contractions that were totally painless (didn't have that on just gas and air)

I think we (as the collective we) have been told so often about how horrific labour is that we don't believe that lower interventions can work.

OP, have you explored whether you have tokophobia? Fear of giving birth? I went through my first pregnancy and birth with undiagnosed tokophobia and really, really wish someone had identified it. If there is any chance that’s you, I’d suggest raising it now as there is a lot that can be done to help. You could have a very positive birthing experience and as PPs have said, every C-section poses more risks so if you wanted multiple children then that’s something to consider. If you do go down the natural route, have a robust birthing plan, be prepared for a c-section and do not under any circumstances be fobbed off if you feel something’s not right during the birth.

It's definitely worth doing hypnobirthing whether or not you end up using it, it's a good skill to have regardless.

I do understand what you're saying, I felt similar. I decided to go with homebirth with birth pool and hypnobirthing but told the midwives I had a low tolerance for transfer (ie transfer at the first sniff of any issue). I had a straightward birth despite waters going first, back to back labour, cord around baby's neck.

You won't get told positive stories because people don't like to share them, you'll only ever be told horror stories.

I can't recommend the Aniball enough. I have just had a successful VBAC. 30 minutes of active labour, 30 minute pushing stage. She came out with her hand up by her head and I had no tearing at all. I used it daily from 37 weeks. It not only helped me prepare for the experience of birthing my baby, but also helped to train my perineum. I recommend reading the clinical study report for more info.
I also did Hypnobirthing.
My first was born by EMCS and my recovery was horrendous. This time, I was walking my eldest to nursery after a few days.

I'll echo the love for the birth pool. I had two water births and would have a third birth in water if I ever got pregnant again. It made such a difference!

My experience of birth is that my body took over and knew what to do. Yes, it was painful and I learned ways of managing and coping with that pain - mainly in the moment, but my body did what it was designed to do. The midwives said after he'd arrived that I did well (not that I'm special, they'll say it to every mum) but I just responded that I didn't do much, it happened to me and there wasn't much I could do about it

Ypu have the choice of either option but please try not to let fear dictate that choice.

For what it's worth, I had an cs with my second and between the two, I'd pick a vb any day. Looking back I, also think my section recovery affected my bonding with DS too, though it took me a while to admit that, and even longer to say it out loud to anyone but DH.

There is no right or wrong, just what's right for you, but again, don't let fear of something your body is designed to do be the determining factor.x

You won't get told positive stories because people don't like to share them, you'll only ever be told horror stories.

This is true, I had a really positive birth experience but I will only share it if someone directly asks me (which doesn’t happen often!) I know it’s a sensitive subject for a lot of people and I don’t want to upset anyone by bringing it up.

I didn’t breastfeed for long but I’ve heard others say the same about breastfeeding; a lot of women find it hard so those who found it straightforward don’t always like to mention it in case it upsets those who struggled.

@milliondollardress yep. Or you get attacked for 'bragging' or daring to suggest that some women have positive births.

Not always. I was home the next day and driving in three weeks.

I was too terrified of tearing and episiotomy in a VB so I researched and here is what I found can reduce the risks:

• Remaining fit/exercising during pregnancy: women who exercise during pregnancy have a lower risk of instrumental delivery, which is linked to a higher incidence of tearing
• Giving birth on any other position than lying on your back: on your side, on all four, squatting, etc...
• Labouring down, gentle pushing, as opposed to forceful pushing
• Perineal massages

I wrote a birth plan that insisted on the second and third point, eventually, it all went tits up during labour: I had a very long labour (25 hours) as my waters broke before labour started, though it wasn't that bad with epidural; though I asked for a "walking epidural" in order to remain mobile during labour, even with the lowest dose of epidural my blood pressure had dropped too much to be able to walk, or even position myself in all fours; I had to give birth on my back as it was the only position the baby would descend and I had to do forced pushing as the baby's heart rate was starting to slow down and I had to get him out soon. Eventually, I only had a first degree tear that healed very quickly. I was able to have vaginal intercourse one month after birth and it didn't hurt a bit.

A word about Aniball/Epino: I knew it was highly controversial, and I decided to use ot anyway, alongside with perineal massages and other birth preparation. Perineal massages didn't work for me as I found it hard to reach. My partner was happy to help but, to be honest, in the weeks before birth I much prefered to spend our time together doing romantinc evenings, or social outings, or letting him go out with his friends rather than spending our evenings doing unpleasant perineal massages. I found Epino much more convenient as I could use it by myself during the day as I was on maternity leave: I would lie down comfortably and watch a serie while doing epino exercises for half an hour. Eventually I attribute the fact that I only got a first degree tear with only two stitches to the use of Epino (and the midwives who directed the pushing well). Worth every cent I spent, IMO.

The only advice I would give you is to research about birth and post-partum recovery and, whatever you decide, prepare yourself well and for all scenarios. Learn how to care for a episiotomy scar, how to prevent and treat piles, how to massage a c-section scar, stock up on food high in fibers to avoid constipation and piles (valid whether you opt for vaginal birth or c-section), buy witch hazel, epsom salt, a peri bottle, etc...

I was outright terrified of a vaginal birth. To the point that I put off getting pregnant and always assumed I would never have children. I was scared of the effect on my body but I was also afraid of the baby suffering birth injuries so the whole thing was just abhorrent to me and from the second I found out I was pregnant (I’m 37) I couldn’t sleep for worrying about it. I was diagnosed with tokophobia and had an elective c section. I didn’t relax until it was booked, and it was booked for 38+6 as I was scared I’d go into labour and they wouldn’t let me have it. It was a calm, relaxed and joyful experience. I recovered very quickly (I was active throughout pregnancy, I ran a marathon at the start of my second trimester and a jogged a 5k on the day I had my DD, I know I was lucky to be well enough to do that as some women have terrible pregnancies but I do think it helped). My scar is tiny, I can’t actually believe they got DD out of such a small opening 😬 I can’t have any more children - unrelated reasons - but if I could I would 100% have a c section again.

I had an ELCS because my baby was breech and it was embarrassingly easy. I was achy and a bit uncomfortable, but up and about in less than 24 hours. Had skin to skin immediately, breastfed, can barely see the scar, I don't have an overhang etc. The recovery from wisdom tooth removal was about a million times worse.

I'm pregnant with #2 and point blank refused to even consider a VBAC. Vaginal birth doesn't appeal - forceps, clitoral tears, episiotomies, mooing on all fours and shitting yourself - not really my vibe. I file alongside bungee jumping and running ultra marathons as "good for you, NOT FOR ME".

This is really good advice.

Bit of a weird question, but are you French? I know the Epi-no is more widely used in France, and some of your turns of phrase sound a little bit French!

Totally agree. Same for me.

C section for second baby was the BEST decision I ever made, coupled with an indie midwife for everything else. Recovery (for me) was a dream. Recovery from my first, 4.5 years ago now.. is 3 surgeries down and ongoing in the mental health department.

but, the truth is no one here can share their experience in any way that will make a jot of difference to you.

Some ladies will literally breathe out their baby and be down the shops the next day. Some will, unfortunately, not. Some like me will be right as rain 6/7 days post section, some, will not. There are 1001 variable- your body, the environment, your support, the baby’s exact position how that works with your body, how you heal, how you perceive each an every situation your faced with during birth. The only thing you can do is consider your options (you do have options), and any certainties and take hope from making the decisions you can and accepting what you can’t control.

(as an aside it is your absolute right to birth how you want in terms of planned section Vs no planned section, if you get an answer you don’t like, remind that HC’P’ of the NICE guidelines and your right to choose. It is not without considerable risk, but that’s your decision to make- not theirs)

good luck to you

@RosaBonheur
Thanks! Yes I am.